tbuckley/cabot-search huggingface dataset:
Short and long term mortality associated with foodborne bacterial gastrointestinal infections: registry based study * Commentary: matched cohorts can be useful
Authors: M. Helms
Journal: BMJ (2003)

<h3>Abstract</h3> <b>Objectives:</b> To determine the excess mortality associated with infections with <i>Salmonella</i>, <i>Campylobacter</i>, <i>Yersinia</i><i>enterocolitica,</i> and <i>Shigella</i> and to examine the effect of pre-existing illness. <b>Design:</b> Registry based, matched cohort study. <b>Setting:</b> Denmark. <b>Participants:</b> 48 857 people with gastrointestinal infections plus 487 138 controls from the general population. <b>Main outcome measure:</b> One year mortality among patients with gastrointestinal infections compared with controls after adjustment for comorbidity. <b>Results:</b> 1071 (2.2%) people with gastrointestinal infections died within one year after infection compared with 3636 (0.7%) controls. The relative mortality within one year was 3.1 times higher in patients than in controls. The relative mortality within 30 days of infection was high in all four bacterial groups. Furthermore, there was excess mortality one to six months after infection with <i>Yersinia enterocolitica</i> (relative risk 2.53, 95% confidence interval 1.38 to 4.62) and from six months to one year after infection with <i>Campylobacter</i> (1.35, 1.02 to 1.80) and <i>Salmonella</i> (1.53, 1.31 to 1.79). <b>Conclusions:</b> Infections with all these bacteria were associated with an increased short term risk of death, even after pre-existing illnesses were taken into account. <i>Salmonella</i>, <i>Campylobacter,</i> and <i>Yersinia enterocolitica</i> infections were also associated with increased long term mortality.
The Nature of Suffering and the Goals of Nursing
Journal: JAMA (2008)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Bilateral Tuberculous Osteomyelitis of Medial Humeral Condyles
Authors: James M. Shea
Journal: JAMA (1982)

SINCE tuberculosis is now uncommon in the United States,<sup>1</sup>the diagnostic index of suspicion may be low when unusual modes of presentation are encountered. We describe here an unusual case of nonpulmonary tuberculous infection as a reminder that this disease continues to appear in North America. <h3>Report of a Case</h3> A 47-year-old man, seen in April 1979, stated that open wounds had developed over the inner aspect of both elbows in September 1978. He worked in a meatprocessing plant, handling meat that was being processed in brine and other liquids. He frequently had to work before a high wooden table that was always wet; while engaged in this activity, he repeatedly rubbed the inside of the elbows, eventually leading to the appearance of an ulceration at the inner aspect of each elbow. He had been treated with antibiotics, but his wounds had failed to heal, and in fact had
Rapid tranquillisation in psychiatric emergency settings in India: pragmatic randomised controlled trial of intramuscular olanzapine versus intramuscular haloperidol plus promethazine
Authors: Nirmal S Raveendran, Prathap Tharyan, Jacob Alexander, Clive Elliot Adams
Journal: BMJ (2007)

<b>Objective</b> To compare the effect of intramuscular olanzapine with intramuscular haloperidol plus promethazine on rapid tranquillisation of agitated or violent people with mental illness. <b>Design</b> Pragmatic, allocation concealed, randomised controlled trial. <b>Setting</b> Emergency services of a general hospital psychiatry department in Vellore, south India. <b>Participants</b> 300 adults with agitated or violent behaviour as a result of mental illness; 150 randomised to intramuscular olanzapine and 150 randomised to intramuscular haloperidol plus promethazine. <b>Interventions</b> Open treatment with intramuscular olanzapine or intramuscular haloperidol plus promethazine. <b>Main outcome measures</b> Primary outcome was proportion of patients who were tranquil or asleep at 15 minutes and 240 minutes. Secondary outcomes were proportion of patients who were tranquil, asleep, restrained, absconding, or clinically improved at 15, 30, 60, 120, and 240 minutes; additional medical interventions and adverse effects over four hours; and compliance with oral drugs and adverse effects over two weeks. <b>Results</b> Of 300 people randomised to receive either intramuscular olanzapine or intramuscular haloperidol plus promethazine, follow-up data were available for primary outcomes for 298 (99%). Both treatments resulted in similar proportions of people being tranquil or asleep at 15 minutes (olanzapine 131/150 (87%), haloperidol plus promethazine 136/150 (91%); relative risk 0.96, 95% confidence interval 0.34 to 1.47) and 240 minutes (olanzapine 144/150 (96%), haloperidol plus promethazine 145/150 (97%); relative risk 0.99, 0.95 to 1.03). However, more people given olanzapine than those given haloperidol plus promethazine required additional drugs over four hours (65/150 (43%) <i>v</i> 31/150 (21%); relative risk 2.07, 1.43 to 2.97). Adverse effects were uncommon with both treatments. <b>Conclusions</b> Intramuscular olanzapine and intramuscular haloperidol plus promethazine were effective at rapidly tranquillising or sedating agitated or violent patients with mental illness but the combination resulted in fewer additional medical interventions within four hours of intervention. <b>Trial registration</b> Clinical trials NCT00455234.
Physicians, AIDS, and Occupational Risk
Authors: Abigail Zuger
Journal: JAMA (1987)

The profound reluctance of some physicians to care for patients with acquired immunodeficiency syndrome prompted us to review medical responses to other historic plagues. No consistent professional tradition emerged. Many physicians, including Galen and Sydenham, fled from patients with contagious epidemic diseases. Many of their colleagues, at considerable personal risk, remained behind to care for plague victims. This inconsistency suggests that an ethic stressing traditional professional duties may not be ideal for defining the optimal relation of the medical profession to patients with acquired immunodeficiency syndrome. A new professional ethic to guide physicians in the acquired immunodeficiency syndrome pandemic is needed. This ethic cannot be entirely derived from these patients' right to health care, which is primarily a claim against society rather than individual practitioners. Civil and professional proscriptions against negligence or abandonment apply only to therapeutic relationships after they are contracted. However, a professional duty to treat human immunodeficiency virus—infected persons could be based on the understanding of medicine as a moral enterprise. In this context, treating human immunodeficiency virus—infected persons is a virtuous act, which meets both patients' and society's health needs and affirms the moral mission of health care. (<i>JAMA</i>1987;258:1924-1928)
Prevalence of HIV Infection Among Intravenous Drug Users in the United States
Authors: Robert A. Hahn
Journal: JAMA (1989)

We reviewed 92 published and unpublished studies of the prevalence of infection with the human immunodeficiency virus (HIV) among intravenous drug users (IVDUs) in the United States. Human immunodeficiency virus seroprevalence among IVDUs in drug treatment programs in the United States ranged from 0% to 65%. Seroprevalence was highest in the Northeast (10% to 65%) and Puerto Rico (45%to 59%); lower in the South Atlantic (7% to 29%) and in the metropolitan areas of Atlanta, Ga (10%), Detroit, Mich (7% to 13%), and San Francisco, Calif (7% to 13%); and 5% or less in other areas of the West, the Midwest, and the South. Among IVDUs seen in drug treatment programs, risk of infection was not associated with gender or age but was associated with black and Hispanic ethnicity, male homosexual orientation, and certain intravenous drug—use practices. Cross-sectional and cohort studies indicated increases in seroprevalence of between 0% and 14% per year among IVDUs in treatment. We estimated that between 61 000 and 398 000 IVDUs in the United States were infected with human immunodeficiency virus, or 5% to 33% of the IVDU population. High rates of infection among IVDUs in treatment in the Northeast indicate the potential for rapid spread in regions where rates are currently low. An urgent need exists to monitor human immunodeficiency virus infection levels and trends more widely and to develop effective programs to reduce the further spread of human immunodeficiency virus infection among IVDUs. (<i>JAMA</i>. 1989;261:2677-2684)
Pituitary Sarcoma
Authors: Arnold H. Greenhouse
Journal: JAMA (1964)

A 31-year-old woman, who had received two courses of x-ray therapy for acromegaly, died after three attempts to remove a rapidly recurring pituitary sarcoma. There are seven previously described examples of this tumor and six of these patients had also received radiation for pituitary adenoma. Large tissue x-ray doses (averaging 7,220 roentgens) were given. Long latent periods (averaging 10.4 years) existed between the initial treatment and the onset of the sarcoma. This material provides strong presumptive evidence that radiation was responsible for these neoplasms. X-ray therapy is quite valuable in the management of pituitary tumors, but caution is advised in the use of large tissue doses.
Routine Preoperative Screening for HIV
Authors: Michael D. Hagen
Journal: JAMA (1988)

EVEN among our society's leaders, the growing epidemic of human immunodeficiency virus (HIV) infection has produced panic. A presidential candidate (<i>New York Times</i>, June 7, 1987, section 4, p 1) and a US senator (<i>Wall Street J</i>, June 18,1987, p 33) have suggested that we quarantine people who are infected. School boards have barred seropositive children from the classroom; ministers have excluded them from church.<sup>1</sup>A clergyman has proposed that police officers should be authorized to shoot anyone suspected of being infected if that person threatens to bite them (<i>USA Today</i>, Aug 14,1987, p 3A). Some of our colleagues would refuse to provide care to infected patients.<sup>2</sup>None of these responses are either reasonable or humane. To criticize them, however, is not enough. We also must examine critically our profession's reactions to the crisis. As physicians, we must be logical in our responses and responsible in our leadership.
Promoting Cancer Prevention Activities by Primary Care Physicians
Authors: Stephen J. McPhee
Journal: JAMA (1991)

<h3>Background.</h3> —Previous interventions to promote performance of cancer prevention activities have largely targeted physicians in university-based practices. <h3>Methods.</h3> —We randomly assigned 40 primary care physicians in community-based practices to either (1) Cancer Prevention Reminders, computer-generated lists of overdue screening tests, and smoking and dietary assessment and counseling, supplemented by cancer education materials; or (2) controls. For each physician, we reviewed a random sample of 60 medical records for data about screening test, assessment, and counseling performance during 12-month preintervention and intervention periods. We calculated performance scores as percentage compliance with American Cancer Society and/or National Cancer Institute recommendations. Multiple regression analyses provided estimates of incremental differences in performance scores between intervention and control groups. <h3>Results.</h3> —Controlling for preintervention performance levels, significant incremental differences in performance scores between intervention and control groups (<i>P</i>&lt;.05) were achieved for nine maneuvers: stool occult-blood test, + 14.5; rectal examination, + 10.5; pelvic examination, +11.8; Papanicolaou's smear, + 30.7; breast examination, + 8.7; smoking assessment, + 10.2; smoking counseling, + 17.3; dietary assessment, + 12.3; and dietary counseling, + 13.9. Increments for sigmoidoscopy and mammography were not significant. <h3>Conclusion.</h3> —Computerized reminders can significantly increase physicians' performance of cancer prevention activities in community-based practices. (<i>JAMA</i>. 1991;266:538-544)
Protective α1-antitrypsin effects in autoimmune vasculitis are compromised by methionine oxidation
Authors: Maximilian Ebert, Uwe Jerke, Claudia Eulenberg-Gustavus, Lovis Kling, Dieter Jenne, Marieluise Kirchner, Philipp Mertins, Markus Bieringer, Saban Elitok, Kai-Uwe Eckardt, Adrian Schreiber, Alan D. Salama, Ralph Kettritz
Journal: Journal of Clinical Investigation (2022)

BackgroundAntineutrophil cytoplasmic autoantibody-associated (ANCA-associated) vasculitidies (AAV) are life-threatening systemic autoimmune conditions. ANCAs directed against proteinase 3 (PR3) or myeloperoxidase (MPO) bind their cell surface-presented antigen, activate neutrophils, and cause vasculitis. An imbalance between PR3 and its major inhibitor α1-antitrypsin (AAT) was proposed to underlie PR3- but not MPO-AAV. We measured AAT and PR3 in healthy individuals and patients with AAV and studied protective AAT effects pertaining to PR3- and MPO-ANCA.MethodsPlasma and blood neutrophils were assessed for PR3 and AAT. WT, mutant, and oxidation-resistant AAT species were produced to characterize AAT-PR3 interactions by flow cytometry, immunoblotting, fluorescence resonance energy transfer assays, and surface plasmon resonance measurements. Neutrophil activation was measured using the ferricytochrome C assay and AAT methionine-oxidation by Parallel Reaction Monitoring.ResultsWe found significantly increased PR3 and AAT pools in patients with both PR3- and MPO-AAV; however, only in PR3-AAV did the PR3 pool correlate with the ANCA titer, inflammatory response, and disease severity. Mechanistically, AAT prevented PR3 from binding to CD177, thereby reducing neutrophil surface antigen for ligation by PR3-ANCA. Active patients with PR3-AAV showed critical methionine-oxidation in plasma AAT that was recapitulated by ANCA-activated neutrophils. The protective PR3-related AAT effects were compromised by methionine-oxidation in the AAT reactive center loop but preserved when 2 critical methionines were substituted with valine and leucine.ConclusionPathogenic differences between PR3- and MPO-AAV are related to AAT regulation of membrane-PR3, attenuating neutrophil activation by PR3-ANCA rather than MPO-ANCA. Oxidation-resistant AAT could serve as adjunctive therapy in PR3-AAV.FUNDINGThis work was supported by KE 576/10-1 from the Deutsche Forschungsgemeinschaft, SCHR 771/8-1 from the Deutsche Forschungsgemeinschaft, grant 394046635 - SFB 1365 from the Deutsche Forschungsgemeinschaft, and ECRC grants.
Programmed Upregulation of HSP70 by Metal‐Organic Frameworks Nanoamplifier for Enhanced Microwave Thermal‐Immunotherapy
Authors: Wenna Guo, Meng Niu, Zengzhen Chen, Qiong Wu, Longfei Tan, Xiangling Ren, Changhui Fu, Jun Ren, Deen Gu, Xianwei Meng
Journal: Advanced Healthcare Materials (2022)

Abstract Thermotherapy can directly kill tumor cells whilst being accompanied by immune‐enhancing effects. However, this immune‐enhancing effect suffers from insufficient expression of immune response factors (e.g., heat shock protein 70, HSP70), resulting in no patient benefiting due to the recurrence of tumor cells after thermotherapy. Herein, a nanoengineered strategy of programmed upregulating of the immune response factors for amplifying synergistic therapy is explored. Metal‐organic frameworks nanoamplifiers (teprenone/nitrocysteine@ZrMOF‐NH 2 @L‐menthol@triphenylphosphine, GGA/CSNO@ZrMOF‐NH 2 ‐LM‐TPP nanoamplifier, and GCZMT nanoamplifier) achieve excellent microwave (MW) thermal‐immunotherapy by programmed induction of HSP70 expression. After intravenous administration, GCZMT nanoamplifiers target the mitochondria, and then release nitric oxide (NO) under MW irradiation. NO inhibits the growth of tumor cells by interfering with the energy supply of cells. Subsequently, under the combination of MW, NO, and GGA, HSP70 expression can be programmed upregulated, which can induce the response of cytotoxic CD4 + T cells and CD8 + T cells, and effectively activate antitumor immunotherapy. Hence, GCZMT nanoamplifier‐mediated MW therapy can achieve a satisfactory therapeutic effect with the tumor inhibition of 97%. This research offers a distinctive insight into the exploitation of metal‐organic frameworks nanoamplifiers for enhanced tumor therapy, which provides a new approach for highly effective cancer treatment.
Targeted Delivery of PD‐L1‐Derived Phosphorylation‐Mimicking Peptides by Engineered Biomimetic Nanovesicles to Enhance Osteosarcoma Treatment
Authors: Wei Wu, Haoyu Guo, Doudou Jing, Zhenhao Zhang, Zhicai Zhang, Feifei Pu, Wenbo Yang, Xin Jin, Xin Huang, Zengwu Shao
Journal: Advanced Healthcare Materials (2022)

Osteosarcoma is a rare malignant bone-originating tumor that usually occurs in young people. Programmed cell death 1 ligand 1 (PD-L1), an immune checkpoint protein, is highly expressed in osteosarcoma tissues. Several recent studies have indicated that the tumor-related role of PD-L1 in tumors, especially non-plasma membrane (NPM)-localized PD-L1, is not limited to immune regulation in osteosarcoma. Here, mass spectrometry analysis is combined with RNA-seq examination to identify the intracellular binding partners of PD-L1 and elucidate the underlying mechanism of its action. It is found that the NPM-localized PD-L1 interacted with Insulin-like growth factor binding protein-3 (IGFBP3) to promote osteosarcoma tumor growth by activating mTOR signaling. This interaction is enforced after phosphoglyceratekinase1 (PGK1)-mediated PD-L1 phosphorylation. Based on these findings, a phosphorylation-mimicking peptide is designed from PD-L1 and it is encapsulated with a Cyclic RGD (cRGD)-modified red blood cell membrane (RBCM) vesicle (Peptide@cRGD-M). The Peptide@cRGD-M precisely delivers the PD-L1-derived phosphorylation-mimicking peptide into osteosarcoma lesions and significantly promotes its therapeutic effect on the tumor. Therefore, this investigation not only highlights the function of NPM-localized PD-L1, but also uses an engineering approach to synthesize a small molecular peptide capable of inhibiting osteosarcoma growth.
H3.3-G34 mutations impair DNA repair and promote cGAS/STING-mediated immune responses in pediatric high-grade glioma models
Authors: Santiago Haase, Kaushik Banerjee, Anzar A. Mujeeb, Carson S. Hartlage, Fernando M. Núñez, Felipe J. Núñez, Mahmoud S. Alghamri, Padma Kadiyala, Stephen Carney, Marcus N. Barissi, Ayman W. Taher, Emily K. Brumley, Sarah Thompson, Justin T. Dreyer, Caitlin T. Alindogan, Maria B. Garcia-Fabiani, Andrea Comba, Sriram Venneti, Visweswaran Ravikumar, Carl Koschmann, Ángel M. Carcaboso, Maria Vinci, Arvind Rao, Jennifer S. Yu, Pedro R. Lowenstein, Maria G. Castro
Journal: Journal of Clinical Investigation (2022)

Pediatric high-grade gliomas (pHGGs) are the leading cause of cancer-related deaths in children in the USA. Sixteen percent of hemispheric pediatric and young adult HGGs encode Gly34Arg/Val substitutions in the histone H3.3 (H3.3-G34R/V). The mechanisms by which H3.3-G34R/V drive malignancy and therapeutic resistance in pHGGs remain unknown. Using a syngeneic, genetically engineered mouse model (GEMM) and human pHGG cells encoding H3.3-G34R, we demonstrate that this mutation led to the downregulation of DNA repair pathways. This resulted in enhanced susceptibility to DNA damage and inhibition of the DNA damage response (DDR). We demonstrate that genetic instability resulting from improper DNA repair in G34R-mutant pHGG led to the accumulation of extrachromosomal DNA, which activated the cyclic GMP–AMP synthase/stimulator of IFN genes (cGAS/STING) pathway, inducing the release of immune-stimulatory cytokines. We treated H3.3-G34R pHGG–bearing mice with a combination of radiotherapy (RT) and DNA damage response inhibitors (DDRi) (i.e., the blood-brain barrier–permeable PARP inhibitor pamiparib and the cell-cycle checkpoint CHK1/2 inhibitor AZD7762), and these combinations resulted in long-term survival for approximately 50% of the mice. Moreover, the addition of a STING agonist (diABZl) enhanced the therapeutic efficacy of these treatments. Long-term survivors developed immunological memory, preventing pHGG growth upon rechallenge. These results demonstrate that DDRi and STING agonists in combination with RT induced immune-mediated therapeutic efficacy in G34-mutant pHGG.
A mitofusin 2/HIF1α axis sets a maturation checkpoint in regenerating skeletal muscle
Authors: Xun Wang, Yuemeng Jia, Jiawei Zhao, Nicholas P. Lesner, Cameron J. Menezes, Spencer D. Shelton, Siva Sai Krishna Venigalla, Jian Xu, Chunyu Cai, Prashant Mishra
Journal: Journal of Clinical Investigation (2022)

A fundamental issue in regenerative medicine is whether there exist endogenous regulatory mechanisms that limit the speed and efficiency of the repair process. We report the existence of a maturation checkpoint during muscle regeneration that pauses myofibers at a neonatal stage. This checkpoint is regulated by the mitochondrial protein mitofusin 2 (Mfn2), the expression of which is activated in response to muscle injury. Mfn2 is required for growth and maturation of regenerating myofibers; in the absence of Mfn2, new myofibers arrested at a neonatal stage, characterized by centrally nucleated myofibers and loss of H3K27me3 repressive marks at the neonatal myosin heavy chain gene. A similar arrest at the neonatal stage was observed in infantile cases of human centronuclear myopathy. Mechanistically, Mfn2 upregulation suppressed expression of hypoxia-induced factor 1α (HIF1α), which is induced in the setting of muscle damage. Sustained HIF1α signaling blocked maturation of new myofibers at the neonatal-to-adult fate transition, revealing the existence of a checkpoint that delays muscle regeneration. Correspondingly, inhibition of HIF1α allowed myofibers to bypass the checkpoint, thereby accelerating the repair process. We conclude that skeletal muscle contains a regenerative checkpoint that regulates the speed of myofiber maturation in response to Mfn2 and HIF1α activity.
Microtubes with gradient decellularized porcine sciatic nerve matrix from microfluidics for sciatic nerve regeneration
Authors: Binghui Jin, Yunru Yu, Xiangxiang Chen, Yanhong Yang, Yushan Xiong, Young Jun Im, Yuanjin Zhao, Jian Xiao
Journal: Bioactive Materials (2022)

Long-range peripheral nerve defect is a severe and worldwide disease. With the increasing development of tissue engineering, the excellent ability of nerve extracellular matrix (ECM) in peripheral nerve injury (PNI) has been widely studied and verified. Here, we present a novel microtube that contains gradient decellularized porcine sciatic nerve ECM hydrogel (pDScNM-gel) from microfluidics for sciatic nerve regeneration. The pDScNM is confirmed to enhance cell proliferation and migration, and improve the axon growth of primary dorsal root ganglions (DRGs) in a concentration-related manner. These behaviors were also achieved when cells were co-cultured in a gradient pDScNM microtube. The